Provider Information for 1518591825
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NICHOLA LYDON LCSW, CPRS
Other Names:Other Name:Mrs. NICHOLA LYDON LCSW, LCADCSex: Female
NPI: 1518591825
Last Updated: 2024-12-24
Certification Date: 2024-12-24
Certification Date: 2024-12-24
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1518591825 | ||||||||||||||||||||
| Enumeration Date | 2020-02-25 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 11 HALSTED ST APT B NEWTON, NJ 07860-2086 United States Phone: 973-362-6010 | Fax:888-466-2358 | ||||||||||||||||||||
| Primary Practice Address | 11 HALSTED ST APT B NEWTON, NJ 07860-2086 United States Phone: 973-862-7275 | Fax:888-466-2358 | ||||||||||||||||||||
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